Uninsured Won't Flock to States With Expanded Medicaid Coverage: Study

MONDAY, Jan. 6, 2014 -- New research suggests that states that choose to expand eligibility for Medicaid under the Affordable Care Act shouldn't expect to draw poor people from other states.

"We found no evidence that these states became so-called 'welfare magnets,' attracting low-income individuals from other states," study author Aaron Schwartz, a doctoral candidate in health policy at Harvard School of Public Health, said in a university news release.

The Affordable Care Act expands Medicaid coverage to millions of low-income adults, but a U.S. Supreme Court ruling issued in 2012 gave states the right to choose whether to provide coverage to larger numbers of poor people. Medicaid is government-funded health insurance for the poor.

Several states had already expanded public health insurance to many of these adults in the past decade, and Schwartz and senior study author Benjamin Sommers, assistant professor of health policy and economics at Harvard School of Public Health, looked at the experiences of those states to see if such migration might occur under the Affordable Care Act.

In the new study, researchers examined Arizona, Maine, Massachusetts and New York, which had all expanded eligibility for Medicaid over the past decade.

The researchers said they couldn't find evidence that people moved to those states to take advantage of their more generous Medicaid policies.

"These results suggest that migration will not be a common way for people to obtain Medicaid coverage under [health care reform], and that interstate migration is not likely to be a significant source of costs for states choosing to expand their programs," the study authors wrote.

Another new study from Harvard researchers finds that several states that were among the earliest to expand eligibility for Medicaid -- California, Connecticut and Minnesota, plus Washington D.C. -- didn't encounter a huge rapid influx of enrollees. Instead, enrollment grew slowly and steadily, the researchers reported.

Both studies appear in the January issue of the journal Health Affairs.